Clinical Case Rounds in Child and Adolescent Psychiatry: De Novo Self-Mutilation and Depressive Symptoms in a 17-year-old Adolescent Girl Receiving Depot-Medroxyprogesterone Acetate.
Bibliographic record
Abstract
INTRODUCTION: Contraception-induced mood changes have been identified since the 1960s. To our knowledge, there has been no reported case about self-mutilation associated to any form of contraception. We report the case of a 17-year-old adolescent girl who presented with de novo self-mutilation and depressive symptoms three and a half weeks after the administration of 150 mg of Depot-Medroxyprogesterone Acetate (DMPA). METHOD: Clinical case report and literature review. Possible confounding factors are reviewed. RESULTS: The patient had no personal psychiatric history and no significant family psychiatric history. A DSM-IV diagnosis of "mood disorder due to DMPA with depressive features" was formulated. There was no evidence of abnormal personality functioning. The mental status exam and collateral information validated the severity of her condition. DISCUSSION: DMPA is a birth control method especially useful for adolescent girls and possible secondary mood symptoms should not limit its access. However, since depressive symptoms substantially interfere with daily functioning and may have unfortunate consequences like self-mutilation and suicidal ideation, it is important to remain vigilant regarding the onset of mood symptoms following contraceptive use in adolescent girls. This vigilance should be more specific regarding adolescent girls with a history of mood disorders, anxiety disorders, self-mutilation or family diathesis of these conditions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".